| ObjectiveTo investigate the hemostatic effect and safety of the two different methods of intravenous infusion combined with intraoperative soft tissue injection of tranexamic acid(TXA)and intravenous infusion of tranexamic acid(TXA)in single-segment lumbar open posterior vertebral fusion(PLIF).MethodsSelect 60 patients with spinal degenerative diseases who need to be treated in our department from February 2019 to February 2020.All the selected patients were single segments from the first lumbar vertebra to the fifth lumbar vertebra(L1-L5)Patients with segmental disease,age 48 to 70 years,average age 57.6±5.6 years,body mass index(BMI)19.53-25.95kg/m2,average body mass index 22.68±1.44,60 patients are numbered according to the order of admission,using random number table method Sixty patients were randomly divided into three groups,group A,namely the blank control group,numbered Al-20;group B,tranexamic acid group-simple veins,numbered B1-B20,group C,tranexamil Acid group-intravenous infusion combined with intraoperative soft tissue injection,numbered C1-C20.Group A was injected with 100ml of 0.9%Nacl solution by intravenous administration 30 minutes before the start of the operation,and the end of the operation was injected into the soft tissue of the surgical area before the suture 30ml of 0.9%Nacl solution;Group B added 1g of tranexamic acid(10ml)to 100ml of 0.9%Nacl solution into the patient by intravenous administration 30 minutes before the operation,the end of the operation was injected into the soft tissue of the surgical area before the suture 30ml of 0.9%Nacl solution,group C dissolved 1g of tranexamic acid preparation in 100ml of 0.9%Nacl 30min before surgery The solution was injected into the patient’s body by intravenous administration.At the end of the operation,1 g of TXA injection(10 ml)was added to 20 ml of 0.9%Nacl solution into the soft tissue of the surgical area before the suturing of the suturing edge.Biochemical indicators,blood loss ml and other data,collected data analyzed and processed by SPSS21.0 software,using the form of mean ± standard deviation to represent the continuous variable data,the comparison of the three sets of data using univariate analysis of variance,two sets of continuous variables The t test was used for the comparison of the data,and the x2 test was used for the comparison between the two groups of non-continuous variables(counting data),with a difference of P<0.05 as statistically significant.ResultsAll the data required by the patients during the perioperative period were completely collected.Age group,BMI,blood volume and other indicators were analyzed p>0.05,the difference was not statistically significant,the total blood loss(ml)of the three groups of patients,intraoperative blood loss,Compared with postoperative drainage,invisible blood loss,and hemoglobin value on the first day after surgery,intravenous drip combined with intraoperative soft tissue injection using tranexamic acid or intravenous tranexamic acid alone group was lower than the control group,respectively:((817.07±155.47)to(452.32± 70.98)to(307.24±63.18),(361.50±99.54)to(227.00±41.18)to(150.00±38.11),(265.00±64.20)to(133.00±32.94)to((99.00±46.22),(190.57±49.06)to(91.52 ± 50.92)to(58.24 ± 20.28),(103.80±8.25)to(111.25±8.01)to(117.20±7.80)]The difference was statistically significant(p<0.05),Compared with the data collected by the experimental groups B and C,the difference was also statistically significant.No adverse reactions,thrombotic events and other complications occurred in the 3 groups of patients within 2 weeks and long-term follow-up.ConclusionThe use of tranexamic acid in single-segment lumbar interbody fusion surgery can significantly reduce the bleeding of patients during hospitalization,and intravenous infusion combined with the use of tranexamic acid in the soft tissue of the operation area is better than intravenous infusion of tranexamic acid alone.None of them increased the probability of surgical complications and adverse reactions,which is worthy of recognition in terms of safety. |
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